Non-vocal mentally and physically handicapped persons, such as athetoid persons and the like, have extreme difficulty in communicating even basic desires and needs to those who are charged with their care. This results in a great deal of frustration, both for the handicapped person and for those who care for them.
Attempts have been made in the past to develop machines or devices to bridge the communications gap between handicapped persons and others. Usually, these include a number of selections (identified either by word or picture) and a pushbutton or other selection means which can be used by the person who desires to communicate with others. While machines or selection devices of this type work with stroke victims, they are unusable with severely physically handicapped persons who are incapable of the accuracy required to push the desired pushbutton or move letters on a writing board or the like. Frequently, mentally and physically handicapped persons of the type under consideration here have only limited spastic control over the movement of their extremities. It is impossible for such persons to use their fingers, for example, to accurately hit a selected key on a typewriter or calculator keyboard of standard type. Consequently, switches which can be activated by somewhat sweeping and inaccurate movement of an extremity of the patient must be located in positions to permit the patient to summon an attendant for help and the like. The problem of communicating the actual need, however, still exists.
Devices have been developed as teaching aids for teaching very young children or retarded children by means of picture/word association. Two patents which are of interest in this field are the patents to Cleary, U.S. Pat. No. 3,516,176, and Cleary, U.S. Pat. No. 3,696,525. The U.S. Pat. No. 3,516,176 is directed to a touch directing teaching machine for the purpose of teaching such word/picture association to such children. The machine displays a simple word above three pictures (one of which corresponds to the word). The student or patient is to touch the correct picture; and if this is done, a switch is operated to activate a recorder which produces the word in spoken form from a loudspeaker. If an incorrect picture is touched, a different result is obtained. Although the system of the patent operates to produce a spoken output corresponding to the picture under a pre-established set of conditions, it is not directed to severely physically handicapped persons. All of the switches and pictures and displays are on a vertical panel. Consequently, it is difficult or impossible for severely handicapped persons to operate this device.
The Cleary U.S. Pat. No. 3,696,525 also is directed to a touch teaching system with three picture display panels. A recording including a question is played. The question is usually in a form directing the student to touch the picture corresponding to the question. If the correct picture is then touched after the question is asked, the machine plays an affirmation message and goes on to a new set of pictures and questions. If the incorrect picture is touched, the question is repeated. This is strictly a teaching device and is not used for the purpose of communicating or initiating messages from the student (or handicapped patient) as an effort to communicate with the teacher or attendant. Once again, the structure of this device does not lend itself to use by severely physically handicapped persons.
Another teaching device which is somewhat similar to the Cleary U.S. Pat. No. 3,696,525 system is disclosed in the patent to Serrell, U.S. Pat. No. 3,382,588. In this patent, a system is disclosed which projects an image on a screen. A recording with various commands in it is played with a stop after each command. The child or student then touches an area on the screen which is the correct answer to the question or command. A sensor then responds with an affirmative spoken response and advances the recording to the next question or picture. If the incorrect area of the screen is touched, the first recorded question is repeated. Thus, this device is a response expression interaction device for teaching very young children. It is not at all suitable, however, for use with handicapped persons as a communication initiating device.
Another teaching device which is generally related to those discussed above is disclosed in the patent to Bender, U.S. Pat. No. 3,609,878. Bender discloses a small box which displays a picture of a small number (shown as 3) of multiple choice words appearing beneath clear-topped switches. The device is for the purpose of teaching very young children to associate pictures with words. Selection by pressing on the correct word associated with the picture causes a "reward" operation of the machine. Depression of the incorrect choice rewards in a "punish" response, such as repetition of the question or the requirement for the pressing of a reset button in order to put the machine back in a mode where it again will respond to further depression of the word buttons. The system of this patent, however, is in no way directed to or suitable for use with severely handicapped persons to enable them to initiate communications with others.
It is desirable to provide some means to enable severely physically handicapped persons, who generally also are unable to communicate through normal speech, to initiate communications of their desires, needs, or wants with the persons who are assigned to their care. To be effective, such a device must be capable of operation by the handicapped person in a simple and easy manner to avoid frustration on the part of such a person. Its operation must be simple to understand, since such handicapped persons frequently are also severely mentally retarded. In addition, it should be capable of clear communication with the persons to whom the desires, needs, or wants of the handicapped person are to be directed.